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With open enrollment upon us, I’m getting more and more questions about paying for health care.

If you buy insurance on the health care exchange or you get your health care through an employer, the deductibles are getting larger and larger. Sometimes they’re huge.

Negotiate for a cash price before service is rendered

You may be having a scheduled procedure in an outpatient facility or maybe a minor operation. You go in with insurance, but don’t be surprised if you get a call from the hospital doing some form of “pre-enrollment” with you.

Only it’s not really pre-enrollment. But under the guise of pre-enrollment, they are calling to figure out if you have any ability to pay the deductible your plan has.

It’s not unusual for someone to have a deductible of several thousand dollars. The hospital wants to know if they’re going to get that deductible money. Because in most cases, they’re not; people just don’t have it.

Listen to this from BusinessWeek: Someone in a bronze plan bought on the health care exchange may well have a $6,000 deductible. So you might have a minor procedure that would cost in the range of what the deductible is! It’s all essentially uninsured care by the medical provider. So they’re going to try to get some kind of arrangement out of you to pay that money.

This is where the power of the dollar speaks. If you are someone who can afford to meet the deductible, and you can afford to pay the care provider, try to negotiate a cash discount. In return for cash up-front, they may be willing to do this because they don’t have to worry about the money becoming uncollectible.

But your time to negotiate that is upfront, before any care is provided.

Likewise, if you don’t have the money, and you’re facing one of these big deductibles, you should negotiating a payment plan upfront to keep yourself from being sent to collections and having your credit harmed.

Clark Howard is a consumer expert whose goal is to help you keep more of the money you make. His national radio show and website show you ways to put more money in your pocket, with advice you can trust. More about Clark